Living with uterine fibroids

Benign tumours from smooth muscle tissue that originate from the smooth muscle layer of the uterus, uterine fibroids are so common as to be almost a fact of life. Current figures put the number of women who will have fibroids in the uterus at some point in their lives at 40 per cent and most of whom will never know it.
And it’s really not that much of a deal if the uterine fibroids are small and not causing any uneasiness. Problems arise when they causes pain, affect a pregnancy or becomes a cause of anaemia or other urinary problems.
So what are uterine fibroids and how do we know if they are dangerous or not?
As stated above, the fibroids are tumours that grow in the muscles of the uterus forming round masses inside or just outside the uterus. In most women, these are usually too small to cause any problems or even be noticed.
The problem, although rare, only occurs if a fibroid is growing too fast, using up too much of the body’s blood, causing other uneasiness such as excess pain during the menstrual cycle or leading to problems in conceiving or complicating pregnancy. It may also be cancerous though fortunately the chances of that is less than one per cent.
Most fibroids up to the size of an orange cause no symptoms. For those who do have symptoms, the most common ones include heavy menstrual bleeding, prolonged menstrual periods, pelvic pressure or pain, frequent urination, constipation, backache or leg pains.
In the case of no symptoms, these fibroids are normally detected during an ultrasound included in an annual check-up. Sometimes moderate and large-sized uterine fibroids are felt by a doctor during a manual pelvic examination.
Imaging tests are then done to confirm their presence. However, the mere presence of fibroids is not a reason to treat them.
Treatment is usually only recommended if they are painful, press on other internal organs, bleed and cause anaemia, cause pregnancy problems or are cancerous.
You can treat uterine fibroids using hormonal suppressions taken orally or via injections. A surgical removal of the uterus or hysterectomy is a good option for cancerous fibroids. The lining of the uterus where the fibroid is growing can also be removed. In this option, the endometrial tissue will grow back, and you can start trying for a baby once the treatment is completed.
Another option is a surgical intervention known as Uterine Artery Embolisation (UAE) done. This cuts off the fibroid's blood supply by injecting a plastic plug into the vessel into the blood vessels that feed it.
If you plan to have a family, the most suitable treatment is a laparoscopic myomectomy because it leaves the uterus intact and improves fertility. It’s also a suitable option for those who don’t want their uterus removed or aren’t ready for the side effects that come with uterus removal.
In a laparoscopic myomectomy, the surgeon makes a small incision in your bellybutton. He or she then inserts a laparoscope – a narrow tube fitted with a camera – through that incision into your abdomen. Instruments are then inserted through similar small incisions to cut the fibroid into smaller pieces and remove them through the same incisions. The recovery period is between one to two weeks.
However, there is a chance of recurrence after such a procedure. The cause of these growths is still unknown, so there’s no real way to prevent them.
If you’re above the age of 30, include ultrasound in your annual check-up just to be on the safe side. Prevention is always better than cure, and if cure is needed, the earlier the better.

DR MONGKOL CHANTAPAKUL is an obstetrician-gynaecologist at Samitivej Sukhumvit Hospital. For an appointment, call the Women’s Health Centre at (02) 711 8555-6.